Friday, June 30, 2006

Triage Tales 17

Disclaimer: The following story is a work of fiction. All similarities to people, places, things and events are coincidental by nature.

57 year old male, comes into the ER for dyspnea. A cut and dry case - diagnosed with Chronic Kidney Disease, on dialysis once a week, last session 6 days ago. Coarse crackles over both lung fields.

What is interesting is the interaction between Treatment Officer and the "responsible companion." In this hospital where nurses and doctors are understaffed, underpaid and overworked, delivering laboratory specimens are the domain of the patient's companions. Thus the paradox of allowing only one companion at a time at the ER per patient AND requiring one companion per patient inside hospital premises at all times.

Most patients do not pay taxes. In short, they have a hand to mouth experience. So most of them apply for social assistance to waive the ridiculously low fees (compared to other hospitals). To do this, one has to have lab requests from the ER with prices written by the cashier, to be presented to the Social Worker. This will initiate the socio-economic assessment of the patient through the responsible companion.

Back to our patient. As the Treatment Officer religiously labels the specimens he obtained from the patient earlier and finishes the forms for the lab requests, he instructs the responsible companion to go to the cashier with the forms and have them "priced", or have the fees written on the form.
"These are laboratory requests, have them priced at the cashier so that when you come back, you can queue on the social assistance line."

2 hours later...

Treatment Officer (TO): So, did you have the forms priced already?

Responsible Companion (RC): I went there and they said they were closing at 4PM.

TO: (to himself) The cashier is supposed to be open 24 hours...
(to RC) From where did you say you tried to have these priced?

RC: You did say they were laboratory requests. I went to the laboratory and they said they were closing at 4PM.

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